CPCR BLS

Question 1

Who is most at risk of cardiac arrest?

Answer 1

Trauma
Systemically unwell
Paediatrics
Geriatrics
Iatrogenic (e.g. anaesthetic overdose)
Recently arrested

Question 2

Describe respiratory arrest.

Answer 2

The patient is not breathing - apnoea

Question 3

Describe cardiac arrest/cardiopulmonary arrest.

Answer 3

Patient has no cardiac output

Will also not be breathing

Question 4

What are we aiming to achieve with CPCR?

Answer 4

Perfusion of heart, lungs and brain

ROSC (return of spontaneous circulation)

Question 5

When do we start CPCR?

Answer 5

As soon as we think the patient has crashed

Respiratory arrest will quickly lead to cardiac arrest

Question 6

How can we be prepared for a crash?

Answer 6

Regular CPCR training
Crash kit/box/trolley
Crash alarm (call for help)

Question 7

What is basic life support vs advanced life support?

Answer 7

BLS = CPCR cycle, oxygen therapy
ALS = drug therapy, fluid therapy, cardioversion

Question 8

What things would be useful to have in a crash box?

Answer 8

Airway access e.g. ET tubes, laryngoscope, tube tie, cuff inflator, lidocaine (cats)
IV and IO access e.g. IV catheters, IO needle, IV/IO connectors, superglue, tape, scissors, scalpel blade
Ventilation e.g. paediatric and adult ambu-bag, capnograph connectors, flow regulator
Drugs e.g. adrenaline, atropine, dextrose, propofol, naloxone, dosing charts, ECG pads, 0.9% NaCl drawn up into 10ml syringes

Question 9

What additional equipment can be useful during a crash?

Answer 9

Capnography
Crash record chart
ECG machine
Defibrillator and conduction gel

Question 10

What are the two types of external cardiac compressions?

Answer 10

Cardiac pump (cats and small dogs) = compression of thorax directly over heart
Thoracic pump (med-large breed dogs) = compression of widest point of thorax, caudal thorax or over xiphysternum

Question 11

How do we carry out external cardiac compressions?

Answer 11

Ideally in right lateral recumbency
Compressor on dorsal side of patient
Rate = 100-120 compressions per min
Compress 50% - 2/3rds width/depth of thorax
Need to be able to feel a femoral pulse for every compression
Allow for full elastic recoil of chest between compressions

Question 12

When might we do direct inter-thoracic cardiac compressions?

Answer 12

Large breed dogs
At thoracotomy
When external compressions are not effective

Question 13

How do we carry out IPPV?

Answer 13

Rate = 20 breaths per min
As soon as you suspect respiratory arrest, commence ventilation
Inflate the thorax the ‘normal’ amount for that patient (although less may be safer)

Question 14

What should we be considering in the aftermath of a crash?

Answer 14

Patient has potential to re-arrest
Treat original condition/cause
Communicate with owners
Very upsetting/stressful for personnel involved
Debriefing can be helpful